What is it about?
190 E280A mutation carriers for early-onset Alzheimer's disease were followed for more than 20 years, from 1995 to 2015, observing the age at which they presented any symptoms of depression and when they started with memory loss. The main objective of the study was to determine if the presence of depressive symptoms, years of education, marital status, rural or urban place of residence, or medical history accelerated or delayed the onset of the disease. People with a history of depression deteriorate almost twice as fast compared to those who do not present depression. And in total, having depressive symptoms accelerated the age of onset of dementia between 3 to 5 years, depending on other genes involved. This fact means that these people worsened faster, promptly needing help in all activities of daily living, such as talking, walking, or eating. Marital status also seems to be involved in this rapid progression of the disease. People without a stable partner (single, widowed, separated); presented cognitive impairment 3 years earlier compared to those who were married or in a free union. Within the medical history, it was found that individuals who suffered from thyroid but had treatment presented dementia later. Age was delayed between 5 to 9 years, and death was between 4 to 9 years.
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Why is it important?
The dementia stage is the most devastating stage of the disease. At this stage, more significant complications, risk of falls, hospitalizations, behavior problems, and a more substantial burden for the caregiver are generated. It is the longest stage with the most significant economic effects on families and the health system. Our findings show that depressive symptoms, like the absence of a permanent partner, mainly accelerate the stage of dementia, which is the longest stage and exhausting for the caregiver and family. If this stage could be delayed a bit, we would greatly contribute to the patient's and caregiver's quality of life.
Perspectives
This study is expected to call for good clinical practices and management guidelines. Since although there is no curative treatment for this disease, preventing, detecting, and treating depressive symptoms before Alzheimer's disease begins could be essential for these people with genetic risk. It could help delay the onset of dementia and functional dependence and, consequently, impact the benefit of the patient, caregivers, and society. Taking care of thyroid problems and having good relationships could also mitigate the impact of Alzheimer's disease.
NATALIA ACOSTA-BAENA
Universidad de Antioquia
Read the Original
This page is a summary of: Early Depressive Symptoms Predict Faster Dementia Progression in Autosomal-Dominant Alzheimer’s Disease, Journal of Alzheimer’s Disease, April 2023, IOS Press,
DOI: 10.3233/jad-221294.
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